Dry Eyes and PRK

[Winikor]

After getting some great advice from your doctors, I have decided to go ahead and have the PRK done.  I have one of the worse cases my dr. has seen of dry eyes.  I hope I'm doing the right thing by going thru with the PRK.  I have read a lot about Lasik but there's very little for me to read on PRK.  Can you suggest anything for me as far as informative reading material, e.g. what I can expect, the pros of PRK for dry eyes, what the next few days after surgery will be like?  Thank you.I also never got a second opinion and my eye sight seems to have worsened in the last few months.  Do you suggest I get a second opinion before my surgery at the end of this month?  Thank you.

[Michael J Kutryb, MD]

If you truly have one of the worst cases of dry eyes that your doctor has ever seen, I honestly don't understand why he is proceeding with laser vision correction.  I would be very, very certain that  you had your dry eye situation well under control for several weeks to months before going into this surgery because your dry eye problem may very well come back to bite you after the surgery and you could be quite unhappy.  Now if dry eyes well controlled, responding well to treatment, doing very well - then that is another story.  You could then have an excellent prognosis.  But from what you've told me, I'm just a little confused.  It's kind of like saying your plane is in terrible shape and has some of the worst problems you've ever seen - but then taking off in it anyway.  Your dry eyes - if not controlled - will likely get worse after surgery for an indefinite amount of time.  You may already be on Restasis and flax/fish oil supplements and punctum plugs can be placed post-op if needed.

Michael Kutryb, MD

[Winikor]

I was not able to get your answer until now (pc problems).  Thank you for your reply.  I understand what you are saying and  I suppose that the reason he is going thru with it is b/c I've expressed to him that I am very uncomfortable wearing glasses (difficulty seeing and headaches) and I am unable to wear contacts again.  I understand that with Lasik, there is a cut of the flap but with PRK (which is what he suggested) there is not.  He said that there isn't a problem w/PRK causing my eyes to become any dryer.  My PRK is scheduled for this coming Wednesday and my dr. is away and won't be back until Tuesday.  I now have another issue.  After the PRK, the paperwork says that I cannot rub my eyes.  I will have to put drops in my eyes several times a day and my eyes get stuck together and I always have to pry them open (at night) with my thumb and index finger otherwise I cannot open my eyes in order to put drops in them or to be able to see to get up.  I also have been having severe migraines behind my left eye that go up my head, and down my neck.  I hadn't mentioned that to the opthalmologist b/c I thought it was a sinus problem.  I'm just afraid that a laser going into my eye might make the migraines either come back more often or worse, permanent.  I have not been able to find any articles on this at all.  Can you shed some light on this?  As far as my treatment so far for my dry eyes, I've been on Restasis, flax/fish oil supplements, had punctom plugs placed, use Systane during the day and Genteal Gel before going to bed and sleep with goggles.  I've already seen 3 specialists, one at the Bascom Palmer Eye Institute.  I don't think there's anything else I can do unless there's something new that I'm unaware of.  Again, thank you for your time and I appreciate anything further you can help me with in this respect.
Ms. Winikor

[Winikor]

Under another topic (Right Surgeon for PRK) you had asked my status as far as age, prescription, etc.  That discussion was closed (b/c it took so long for me to reply).  I'm so sorry, I hadn't seen your email.  No pc for awhile.  I am 59 years old, wore contact lenses (Oasis) for 10 years (monovision).  My left eye is 3.25 and the right is 2.00.  I've been wearing glasses due to the fact that the contacts caused problems to my eyes (not sure what the term is) and not only am I not able to see well where I step and wind up tripping a lot, but they cause discomfort on my nose where they sit (although my glasses are lightweight) and on my nose as well (and this causes mild headaches at times).  Thus, PRK was suggested by my opthalmologist.  Thank you again for your help and I'm sorry I hadn't responded sooner.

[Winikor]

I just wrote to Dr. Hagan explaining that I had my PRK done on March 26, 2008.  I wanted to thank you for all of your help and suggestions.  My visions is still blurry and it's difficult for me to stay on the pc.  Thank you again for all of your help.

[Michael J Kutryb, MD]

I'm still not sure you were a good candidate.  I suspect that you might struggle for some time.  Let us know how you do.

MJK MD

[Winikor]

Dear Dr. Kutryb:
I had considered seriously, after reading the first time you wrote that I wasn't a good candidate, to cancel my PRK.  However, my opthalmologist thought that I would do well and that I should not have anymore trouble with my dry eyes after the surgery than before, as long as I keep putting tears and Restasis in my eyes.  I had gone about 2 years ago to the Rand Eye Institute where they also told me I was a candidate for Lasik, but I just didn't feel that Lasik was right with my dry eyes.  I did go ahead with it and as I mentioned in my previous email, have not regained full vision.  I have read that it may take anywhere from two weeks to a few months until that happens.  It has been difficult, to say the least, being that I was under the impression that I would be able to see well enough after 6 days but that it may take up to 6 months for optimum vision.  I did not prepare properly for this, nor did I give my employer enough notice (had told them I'd be out for 6 days only) and it will be 3 weeks on Wednesday, and I cannot drive.  I can read a menu from 6 inches away, so I am getting better but the distance eye is very blurry.  That is my update and I want to thank you again, first for your help and advice and second for your concern.

[Winikor]

Dear Dr. Kutryb:

Yesterday was 4 weeks since my PRK.  I  have seen very little improvement since the first few days.  I have gotten used to my new glasses for nearsightedness since that is what I am now, whereas before I was farsighted.  My dr. said that in time, my vision should improve to the prescription he gave me.  I virtually had no pain after the first week, was light sensitive for over 3 weeks and still am a little but my vision is still blurry.  I can see 6 inches away and now with my right eye, I can see better and better as far as distance but still very hazy.  It's been very frustrating and I was I had been told about how this would be.  I really would not have done it.  I was practically told that I would "probably" be back to work within less than a week.

Just wanted to update you on my situation.

Thank you again for all of your help.